Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
Cytokine. 2018 Oct;110:459-465. doi: 10.1016/j.cyto.2018.05.017. Epub 2018 May 24.
This study aims to investigate the clinical significance of serum soluble CD163 (sCD163) levels as a predictor of the disease activity of systemic juvenile idiopathic arthritis (s-JIA). In this study, we examined 63 patients with s-JIA, four with Epstein-Barr virus-induced hemophagocytic lymphohistiocytosis (EBV-HLH), and seven with Kawasaki disease (KD), along with 14 healthy controls. We quantified serum cytokine levels (sCD163, neopterin, IL-18, IL-6) by enzyme-linked immunosorbent assay and compared the results with the clinical features of s-JIA. Serum sCD163 levels were significantly elevated in patients with s-JIA associated macrophage activation syndrome (MAS) and EBV-HLH compared to those in patients with acute-phase s-JIA and KD. In addition, serum sCD163 levels profoundly increased with the progress of MAS and correlated positively with the disease activity of s-JIA, even in patients receiving tocilizumab. Furthermore, serum sCD163 levels significantly decreased in the inactive phase compared to those in the active phase and normalized in remission. The correlation between macrophage activation and serum sCD163 levels might be a unique indicator of the disease activity and a potential diagnostic laboratory criterion for clinical remission in patients with s-JIA, including those receiving tocilizumab.
本研究旨在探讨血清可溶性 CD163（sCD163）水平作为全身型幼年特发性关节炎（s-JIA）疾病活动的预测指标的临床意义。在这项研究中，我们检测了 63 例 s-JIA 患者、4 例 EBV 诱导的噬血细胞性淋巴组织细胞增生症（EBV-HLH）患者和 7 例川崎病（KD）患者，以及 14 名健康对照者。我们通过酶联免疫吸附试验检测了血清细胞因子水平（sCD163、新蝶呤、IL-18、IL-6），并将结果与 s-JIA 的临床特征进行了比较。与处于急性期的 s-JIA 和 KD 患者相比，s-JIA 相关巨噬细胞活化综合征（MAS）和 EBV-HLH 患者的血清 sCD163 水平显著升高。此外，血清 sCD163 水平随着 MAS 的进展而显著增加，与 s-JIA 的疾病活动呈正相关，甚至在接受托珠单抗治疗的患者中也是如此。此外，与活动期相比，缓解期患者的血清 sCD163 水平显著降低，且恢复正常。巨噬细胞活化与血清 sCD163 水平之间的相关性可能是 s-JIA 患者疾病活动的独特指标，也是包括接受托珠单抗治疗的患者在内的临床缓解的潜在诊断实验室标准。
